Did you know?
The COVID-19 pandemic and response significantly impacted access to and use of healthcare services during the early months of 2020. However, analysis of pharmacy claims data indicate that the pandemic did not have that same effect on pharmacy services. While the average per member per month (PMPM) cost for medical services began to drop in March 2020, and subsequently rebound in July 2020, the cost of pharmacy services has been on the rise since March 2020.
Here is the latest
As described in a previous blog post, the measures taken to slow the spread of COVID-19 impacted peoples’ access to and use of every type of healthcare delivery service, and such changes in utilization are reflected in healthcare claims and corresponding costs. When analyzing medical claims data among commercially insured members, a decline in per member per month (PMPM) costs[1] were observed, beginning in March 2020, reaching their lowest points in April 2020, and rebounding in July 2020. Pharmacy claims data, however, tell a different story. Unlike medical services, pharmacy PMPM costs did not experience a drop during the COVID-19 pandemic. Rather, pharmacy spending increased consistently in 2020 and 2021.
Similar analysis in Massachusetts indicated the same experience. The Center for Health Information and Analysis (CHIA) in Massachusetts reported that while most service categories experienced fluctuations from 2019 to 2021, pharmacy spending increased consistently over the three years.
This data can help us better understand the trajectory for pharmacy per member per month costs in New Hampshire (NH).
Current findings show that pharmacy costs are rising consistently in NH. While the average PMPM costs for most of the top 10 drug classes each year have remained stable for most drug classes, bronchodilators did see a notable increase of $16 from 2019 to 2021. Across all drug classes, per member per month costs have increased by $35 from 2019 to 2021, indicating increased monthly pharmaceutical costs for NH residents with commercial insurance.
This analysis can also help us better understand the trajectory for pharmacy prescribing in NH.
When reviewing the types of drug classes in terms of the frequency of prescriptions (versus cost), findings also show that the rate of prescriptions among several classes are increasing. The drug class with the largest increase in the rate of prescriptions was immunostimulants, which increased by more than 200% over the three years, followed by three drug classes often prescribed for mental health conditions; CNS stimulants (26% increase); anticonvulsants (21% increase); antidepressants (21% increase).
For more details on COVID-19 pharmacy claims recovery in New Hampshire, read the full report.
[1] PMPM reflects the total paid amount for medical services, spread across all the members, for the month.
